Effect of Double Layer Dartos Flap in Reduction of Fistula Rate Post Hypospadias Repair

Objective: To assess the impact of double layer dartos flap on urethro-cutaneous fistula rate reduction and to compare it with single layer dartos flap in Tubularized Incised Plate Urethroplasty (TIPU) for hypospadias in children. Methods: Between January 2008 and month 2011 retrospective charts review for 120 patients who had hypospadias repair by the author. 26 patients were excluded from the study because they were not suitable for TIPU procedure. Therefore, our study sample involved 94 children. Results: Mean age at time of surgery was 16 months (10-96 months), with a mean follow up of 18.2 months (10–36 months). All patients had hypospadias repair by utilizing TIPU. Patients were divided into two groups: Group one involved 50 patients had double layer dartos flap. Group two involved 44 patients had single-layer dartos flap. All patients had stent insertion at the time of repair. 6/44 patients [13.6%] developed fistula in group two and 2/50 patients [4%] in group one had fistula. Conclusions: Dartos coverage appears to have significant effect in reducing urethro-cutaneous fistula in TIPU repair. With double layer dartos coverage further reduction can be achieved.